Many people have small pouches in their colons that bulge outward through weak spots, similar to an inner tube that protrudes through weak places in a tire. Each pouch is called a diverticulum, or diverticula. The condition of having diverticula is called diverticulitis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis. When the pouches become infected or inflamed, the condition is called diverticulitis. This will occur in 10 to 20 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.

Most people with diverticulosis do not have any symptoms or discomfort to speak of. However, symptoms may include bloating, mild cramps, and constipation. Other diseases including irritable bowel syndrome and stomach ulcers cause similar problems. Because of these symptoms it is not an automatic indicator that a person has diverticulosis. Visiting a doctor for a diagnosis is very important if one is having these troubling symptoms. The most common symptom of diverticulitis is abdominal pain. The most common sign is tenderness around the left side of the lower abdomen. If infection is the cause, constipation, fever, nausea, vomiting, chills, and cramping may occur as well. The severity of symptoms depends on the extent of the infection and complications.

It has not yet been proven that a low fiber diet is the main cause of diverticular disease. The disease was first noticed in the United States in the early 1900’s. Around the same time, processed foods were introduced into the American diet. Many processed foods contain low fiber and refined flour. Refined flour, as opposed to whole wheat flour, has no wheat bran, therefore, no fiber. Fiber is the part of fruits, vegetables, and grains that the body is unable to digest. Some fiber dissolves easily in water, called insoluble fiber. Both kinds of fiber help make stools soft and easy to pass. Fiber also helps to prevent constipation. Constipation makes the muscles strain to move stool that is too hard. It is the main cause of increased pressure in the colon. The excess pressure may cause the weak spots in the colon to bulge out and become diverticula.

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As a person gets older, pressure within the colon causes bulging pockets of tissue, or sacs, that push out from the colon walls. A small bulging sac pushing outward from the colon wall is called a diverticulum. More than one bulging sac is referred to as diverticula. Diverticula can occur throughout the colon, but most are common near the end of the left colon. This is referred to as the sigmoid colon. The condition of having these diverticula in the colon is called diverticulosis

Diverticulitis occurs when bacteria get trapped in the pouches. This leads to infection or inflammation. No screening is available at this time for diverticulitis. Starting at age 40, a procedure called a flexible sigmoidoscopy may be recommended every 3 to 5 years or a colonoscopy every 10 years as a screening exam for cancers of the colon and rectum. Both flexible sigmoidoscopy and colonoscopy involve using a flexible tube with a lighted viewing instrument to see inside the large intestine. These exams are often able to reveal diverticula if they are present. Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack.

More serious complications include diverticulitis, abscess in the pelvis, colon obstruction, and bacterial peritonitis, plus bleeding in the colon. A diverticulum can become infected with bacteria and ruptures, causing diverticulitis. Fever, tenderness, and pain of the lower left abdomen are common symptoms. Constipation or diarrhea may also occur. A collection of pus can develop around the inflamed diverticulum, which leads to the formation of an abscess, usually in the pelvis. On rare occasions, the inflamed diverticula can erode into the urinary bladder, which causes a bladder infection and passing of gas during urination. Inflammation of the colon may also lead to bowel obstruction. On rare occasions, a diverticulum ruptures freely into the abdominal cavity causing life threatening infection caused peritonitis.

No screening is available at this time for diverticulitis. Starting at age 40, a procedure called a flexible sigmoidoscopy may be recommended every 3 to 5 years or a colonoscopy every 10 years as a screening exam for cancers of the colon and rectum. Both flexible sigmoidoscopy and colonoscopy involve using a flexible tube with a lighted viewing instrument to see inside the large intestine. These exams are often able to reveal diverticula if they are present. Treatment after recovery from an attack of diverticulitis is aimed at preventing another attack. This treatment may include getting plenty of fluids daily, gradually increasing the amount of fiber in the diet through fruits, vegetables, wheat bran, and the regular use of a fiber supplement. It is also highly recommended that regular doctor visits are conducted to monitor the condition.

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